- CarePlus offers Medicare Advantage plans in select regions of Florida.
- Medicare Advantage plans from CarePlus all include prescription drug coverage.
- If you have original Medicare, you can also purchase a prescription drug plan from CarePlus.
CarePlus is a private health insurance company that offers Medicare Advantage plans to people living in certain parts of Florida.
Medicare Advantage (Part C) is an alternative to original Medicare (parts A and B) that’s provided by a private insurance company. It covers your basic medical benefits, plus additional services that may include dental, hearing, and vision coverage, depending on the plan you choose.
Keep reading to learn more about the Medicare Advantage plans that CarePlus offers.
CarePlus offers Medicare Advantage plans only in the state of Florida. The plans are divided by “market regions” and further break down their coverage by county.
These market regions include:
- Daytona area: Volusia County
- North Florida: Duval and Clay counties
- Orlando area: Lake, Marion, Orange, Osceola, Seminole, and Sumter counties
- South Florida: Broward, Miami-Dade, and Palm Beach counties
- Tampa area: Hillsborough, Pasco, Pinellas, and Polk counties
- Treasure Coast and Space Coast: Brevard and Indian River counties
If you live in one of these service areas, you can compare the available CarePlus Medicare Advantage plans to select the best coverage for your needs.
Below are some examples of plan categories that CarePlus Medicare Advantage plans fall under.
CarePlus Medicare Advantage HMO plans
All the CarePlus Medicare Advantage plans are what’s known as a Health Maintenance Organization (HMO).
With this plan, you’ll first choose a primary care provider from a list of CarePlus-approved providers. Moving forward, you’ll see your primary care provider for your general health needs and when you need a referral to a specialist.
Generally, you’ll need to see providers who are in CarePlus’s network to get the most coverage. If you need emergency care and are outside of your normal service area, though, out-of-network providers will be covered.
Other CarePlus Medicare plans
As mentioned, all CarePlus Medicare plans fall under the HMO category. Within this category, CarePlus also offers a different plan type: Dual Eligible Special Needs Plans (D-SNPs). D-SNPs are designed for people who are eligible for both Medicare and Medicaid.
Specifically, CarePlus offers plans for Medicare members who are also enrolled in Extra Help. Medicare’s Extra Help program offers financial assistance to help pay for your medications.
CarePlus calls this plan the CareNeeds PLUS plan. If you’re shopping for a CarePlus plan and see “SNP” in the plan name, know that you’ll need to meet certain criteria to enroll.
All CarePlus Medicare Advantage plans include prescription drug coverage. This coverage is detailed in the CarePlus Prescription Drug Guide. This guide is also known as a formulary, which is a list of the medications that a Medicare Advantage plan covers.
Medicare requires that you have some form of creditable prescription drug coverage. If you stick with original Medicare (Part A and Part B), you’d need to purchase a separate Part D plan.
Part of the value of Medicare Advantage plans is that they offer additional services beyond what original Medicare covers. For example, some preventive services they might cover include:
- dental benefits
- fitness and exercise classes
- hearing benefits
- preventive care rewards program
- vision benefits
Most CarePlus Medicare Advantage plans also offer services that may help if you need extra care. These include:
- access to a mail-order pharmacy with no delivery fees
- over-the-counter medical spending allowance
- meal program benefits after an inpatient hospital stay
- transportation services
- telehealth services
If you have a question about Medicare Advantage coverage through CarePlus, you can always contact the company directly.
Most CarePlus Medicare Advantage plans are premium-free. Though you’ll still pay your Medicare Part B premium to Medicare, you’ll pay $0 for Medicare Advantage coverage.
It’s important to remember that you must choose CarePlus providers, medications, and pharmacies for CarePlus to provide your Medicare benefits.
Here’s a comparison of CarePlus plans and benefits in select Florida cities.
|City, plan||Star rating||Monthly premium||Yearly health deductible, drug deductible||In-network out-of-pocket max||Primary physician visit copay||Specialist visit copay|
|Daytona Beach, CareOne PLUS (HMO)||5||$0||$0, $0||$3,400||$0||$20|
|Jacksonville, CareOne (HMO)||5||$0||$0, $0||$3,400||$0||$25|
|Fort Lauderdale, CareFree (HMO)||5||$0||$0, $100||$3,400||$0||$25|
|Tampa, CareNeeds PLUS (HMO D-SNP)||5||$0||$0, $0||$1,500||$0||$0|
|Orlando, CareNeeds (HMO D-SNP)||5||$0||$0, $0||$3,400||$0||$0|
These are just a few examples of plans that CarePlus provides. You can see all available plans (or just search for CarePlus plans) in your area by using Medicare’s plan finder tool.
Medicare divides its health coverage into parts.
Part C (Medicare Advantage) offers the same coverage as Part A and Part B, but you purchase these plans through a private insurance company that contracts with Medicare.
When you choose a Medicare Part C plan, Medicare pays the insurance company a set amount. In return, the insurance companies contract with specific providers to receive discounts. The cost savings are then passed on to you through added health coverage offerings.
You’ll still pay your monthly Part B premium to Medicare. This is in addition to any premium associated with your Medicare Advantage plan.
Part D is the portion of Medicare that covers prescription drugs.
Medicare requires that each prescription drug plan cover at least two medications in each key category, such as those for treating blood pressure. These medications will be listed on the plan’s formulary.
Formularies may categorize medications as generic (usually the cheapest) all the way up to premium (name brand), which will cost the most. When choosing a Part D plan, carefully review the formulary to ensure that it includes all or most of the prescription drugs you need.
- Available Medicare Advantage plans vary by geographic region.
- If you see an available CarePlus plan in your region that you’d like to sign up for, you can contact CarePlus directly to enroll.
- Medicare’s plan comparison tool may be the best place to start, so you can compare coverage and costs across different companies and plans in your area.
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